A prospective study of posttransplant cyclophosphamide for unrelated donor peripheral blood stem cell transplant with special attention to graft content and the impact of a higher γδ T cell dose

Chetan Jeurkar; Benjamin Leiby; Shaik Rashid; Usama Gergis; Dolores Grossso; Matthew Carabasi; Joanne Filicko-O'Hara; William O'Hara; Thomas Klumpp; Pierluigi Porcu; Neal Flomenberg; John L Wagner

doi:10.1111/ejh.14221

A prospective study of posttransplant cyclophosphamide for unrelated donor peripheral blood stem cell transplant with special attention to graft content and the impact of a higher γδ T cell dose

Eur J Haematol. 2024 May 6. doi: 10.1111/ejh.14221. Online ahead of print.

Affiliations

¹ Department of Medical Oncology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
² Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

PMID: 38711359
DOI: 10.1111/ejh.14221

Abstract

Posttransplant cyclophosphamide (PtCy) has been shown to decrease post-hematopoietic stem cell transplant acute and chronic graft-versus-host disease (GVHD). In this study, PtCy was used in 44 patients along with mycophenolate and tacrolimus with HLA matched (29) and mismatched (15) unrelated donors to determine the impact of graft content on outcome; thus, all patients had flow cytometric analysis of their graft content including the number of B cells, NK cells, and various T cell subsets. Higher γδ T cell dose was associated with the development of acute GVHD (p = .0038). For PtCy, further studies of the cell product along with further graft manipulation, such as selective γδ T cell depletion, could potentially improve outcomes.

Keywords: GVHD; posttransplant cyclophosphamide; γδ T cells.